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The Parathyroid Glands00:59

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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Imaging Studies II: Ultrasonography01:24

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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
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Imaging Studies III: Computed Tomography01:27

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DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
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Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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Pediatric hyperparathyroidism: review and imaging update.

Hedieh Khalatbari1, Safia H E Cheeney2, Scott C Manning3

  • 1Department of Radiology, University of Washington School of Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA. hedieh.khalatbari@seattlechildrens.org.

Pediatric Radiology
|April 27, 2021
PubMed
Summary

Pediatric hyperparathyroidism, characterized by excess parathyroid hormone, often presents with symptoms. Imaging like ultrasound and scintigraphy aids in localizing affected glands, crucial for diagnosis and treatment planning.

Keywords:
ChildrenComputed tomographyFamilial hyperparathyroidismHyperparathyroidismNeonatal severe primary hyperparathyroidismParathyroid glandsScintigraphy ultrasound

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Area of Science:

  • Endocrinology
  • Pediatric Imaging
  • Genetics

Background:

  • Hyperparathyroidism involves elevated parathyroid hormone secretion, categorized as primary, secondary, or tertiary.
  • Pediatric primary hyperparathyroidism frequently causes symptoms and can be linked to familial forms with genetic mutations.
  • Accurate localization of hyperfunctioning parathyroid glands is essential for effective management.

Purpose of the Study:

  • To review the embryology, anatomy, pathophysiology, and preoperative localization of parathyroid glands in pediatric hyperparathyroidism.
  • To focus on imaging modalities and familial subtypes relevant to pediatric patients.
  • To highlight differences and considerations compared to adult literature.

Main Methods:

  • Review of parathyroid gland embryology, anatomy, and pathophysiology.
  • Evaluation of first-line (scintigraphy, ultrasound) and second-line (CT, MRI) imaging modalities.
  • Discussion of pediatric-specific considerations for imaging protocols and radiation dose optimization.

Main Results:

  • Most symptomatic pediatric patients with sporadic primary hyperparathyroidism present with end-organ damage or nonspecific symptoms.
  • Familial hyperparathyroidism, including calcium-sensing receptor gene mutations, is more prevalent in younger patients.
  • Parathyroid scintigraphy and ultrasound are key initial imaging tools, complemented by CT and MRI for localization.

Conclusions:

  • Preoperative localization of hyperfunctioning parathyroid glands is critical for managing pediatric hyperparathyroidism.
  • Imaging principles for primary hyperparathyroidism localization are applicable to secondary and tertiary forms in pediatrics.
  • Tailored imaging approaches, considering radiation safety, are vital for pediatric patients.